Primary hypothyroidism refers to a systemic hypometabolic status due to hypothyroxinemia or thyroid hormone resistance caused by pathologic changes to the thyroid gland. The main role of thyroid hormone is to promote energy metabolism and facilitate growth and development processes within the body. In a hypothyroidism state caused by thyroid hormone deficiency, the body's thermogenic effect is down-regulated and metabolisms of protein, sugar, and fat were slowed down, which might further lead to cardiovascular disease, hyperlipidemia, myocardial damage and myxedema, as well as other changes. Hypothyroidism tends to be neglected or misdiagnosed due to its trivial and nonspecific clinical manifestations, and a combined renal dysfunction is rarely reported. Herein a case of kidney dysfunction caused by hypothyroidism is reported and relevant literature was reviewed.

Objective: To study and describe the utilization pattern of various classes of drugs including antibiotics in patients with chronic kidney disease (CKD). Materials and Methods: A total of 185 CKD patients were finally recruited after strictly obeying the selection criteria in this cross-sectional, observational study that was conducted over a period of 6 months in Nephrology Department of a tertiary care teaching hospital. Relevant data were extracted by interviewing the patients and from prescriptions, case records, and investigational reports. Results: Mean age of CKD patients was 45.81 ± 11.16 with male predominance (58%). CKD Stage III comprised of the maximum number (28%) of patients. Polypharmacy was executed in 83% of these patients. Hypertension (95%), diabetes (87%), and anemia (86%) are the most common co-morbidities. The five most frequently prescribed drugs were diuretics (100%), anti-ulcer agents like proton pump inhibitors and H 2 blockers (98%), anti-hypertensives (95%), vitamins and minerals supplements including calcium (92%), and hematinics (85%). Infectious diseases like respiratory tract infection (37%) and urinary tract infection (34%) had shown to have a high prevalence in CKD patients. Cefoperazone, metronidazole, piperacillin + tazobactam were the most prescribed parenteral antibiotics. Azithromycin and levofloxacin were the extensively used oral antibiotics. Conclusion: This study demonstrates the variability of drug utilization in CKD patients. Drug utilization studies on a regular basis give a framework to pharmaceutical companies and healthcare providers and help to build management strategies. However, the right choice of drugs and inappropriate doses will reduce the incidence of nephrotoxicity and ultimately result better clinical outcomes. Managing infections and prescribing antibiotics in CKD are crucial and hence claim rationalization of the use of antibiotics to improve the quality of life of CKD patients.

Deterioration of renal function is closely related to renal interstitial fibrosis (RIF). With animal models, we can simulate the pathological changes and progression of disease. Various animal models of RIF are pivotal for clinical treatment and investigation of new drugs. Reviewed here are methods of establishment and mechanism of commonly used animal models of RIF to help researchers select the optimal animal model for different research purposes.

Background and Objectives: Lupus nephritis (LN) is one of the serious manifestations of systemic lupus erythematosus (SLE). It has diversities of clinical and histological presentations. Hence, the main objective of this study is to sort out the clinical and histological varieties of LN in a tertiary care setting of Bangladesh. Materials and Methods: For the study, 30 patients of SLE with renal involvement were selected. Diagnosis of SLE was done on the basis of American Rheumatological Criteria (ACR). After consent, all patients were undergone renal biopsy and tissue was analyzed for histological type and presence or absence of immunoglobulin were also analyzed by direct immuneflurescence study. Data after compilation analyzed by SPSS version 20. Results: All the patients found to have LN were female and most (73.2%) of the patients were at child bearing age between 21 and 40 years. Anti-ds DNA was positive among all (100%) patients and antinuclear antibody was positive among 19 (63%). Among all patients 6 (20%) had ≥3 g proteinuria. The common histological type was found class IV, which was 40% of total patients. A patient of LN found to have histological feature of acute glomerulonephritis. Conclusion: In conclusion, it can be said that LN have varied clinical profile with different histological types.

Ambiguous genitalia is a birth defect where the external genitals do not have the typical appearance of either a boy or girl. An 8-week-old infant presented with persistent vomiting, failure to thrive, and genital ambiguity. On the basis of clinical presentation, a salt-losing variety of congenital adrenal hyperplasia (CAH) was suspected. Hormonal levels were tested and 3 beta-hydroxysteroid dehydrogenase II (HSD3B2) deficiency, a rare CAH variant was suspected. This was confirmed by molecular analysis of the HSD3B2 gene from the affected baby. It revealed the presence of the homozygous P222Q mutation which was found to be heterozygous in both parents.

Renal tubular acidosis is a known clinical entity, in which type I distal renal tubular acidosis (dRTA type I), also known as classical dRTA, is second most common type after dRTA type IV. We report 21-year-old female presenting as polymorphic ventricular tachycardia (VT), which on evaluation was found to have the type I dRTA with idiopathic etiology. Polymorphic VT as presentation of type I dRTA has not been reported in the literature in human beings so far but has been reported in animal models.